HB23-1215

This fee should probably be called a “care-team fee,” because it has little to do with the actual physical facility. The fee is charged when a hospital owns an outpatient care setting (clinic, practice, center) but may not employ the physicians working there.

Facility fees pay for patient care staff and support the broad variety of other staff and services necessary to provide world-class care. The fees in settings outside the “four walls” of the hospital have supported the shift to an integrated model of care that emphasizes preventative, whole-person care prioritized by policymakers. To ensure they can cover costs and be available to care for patients 24/7/365, hospitals charge facility fees that support routine operations and fill gaps created by a fragmented payment system.

Payment and policy changes at the state and federal levels over the past 10-15 years have prioritized integration of health care services across the continuum of care and a focus on population health. This has led to significant investments by hospitals and health systems in primary and specialty care services. These developments have also led to care moving outside the traditional “four walls” of the hospital and into the community leading to better access to care.

Yes. Federal transparency regulations require hospitals to provide clear, accessible pricing information by publicly posting standard charges for all items and services they provide as well as by offering a searchable tool for “shoppable services” patients can schedule in advance. Clinics must include ancillary charges such as facility fees either in the service calculations or as a stand-alone cost with a description of what the charge entails. Colorado patients have the option to pursue legal action against hospitals if the charges they post are inaccurate or incomplete.

Federal law reqruires hospitals and their outpatient clinics to provide uninsured and self-pay individuals with good-ffaith estimates detailing all expected charges — including facility fees. State and federal law also requires for facilities to provide an estimate in advance of any scheduled service, and those rules are currently being drafted.

Now that federal COVID-19 relief money has gone away, more than half of Colorado’s hospitals are operating either in the red or are hardly breaking even, which has resulted in longer wait times, cuts to services like Obstetrics, and reducing the number of beds. Some, though certainly not all, Colorado hospitals had strong financial performance in 2020 and 2021, though much of it was due to investment performance (much like personal 401k). 2022 saw reversal unlike any in decades.

That is simply not true, and is either intentionally misleading or a gross misunderstanding of healthcare finances. Executives’ salaries are set based on the national marketplace – and hospitals recruit the staff needed to oversee and manage their systems in the best interests of their patients and communities. The financial consequences of HB23-1215 are exponentially greater in scale than executive compensation, and focus there only ignores the serious impacts the bill will impose on patients and health care workers. There is no debate among hospital professionals that this reckless bill would limit patient access to care by forcing hundreds of outpatient clinics to close and result in lost jobs for thousands of Colorado care givers who work in them.